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Shaun Munnings is just 49 years old, but she's already had the photographs taken that she wants to be used for her obituary. After being diagnosed with lupus two years ago, she took the photographs because she says she knows that tomorrow is not promised to her.
"People get upset when I talk about death, but I tell them I'm not promised tomorrow, and with lupus, I could die this afternoon from the complications -- that's just how it is."
Munnings has suffered through misdiagnosis after misdiagnosis in her life, going as far back as her childhood when she said would indiscriminately break out in sores and swell up and would be treated for allergies. In her adult years, the trend pretty much continued -- misdiagnosis after misdiagnosis -- from spinal arthritis to one doctor telling her she needed to have surgery. And don't even think about the many different types of medications she's been prescribed over the years. When her mother died in 2007 it all came to a head.
"Everything pretty much went out of control because I was stressed out about my mother's death and grieving. I lost a lot of weight. I had rashes. I had sores in my mouth, and I was extremely tired...not the 'oh, I had a hard day' kind of tired; it was like, 'I can't move my body'. It was like my brain was telling my limbs to move, but it just wasn't working," said Munnings.
As in the past, she sought medical help.
"When the doctor asked me what part of me did I not feel pain, I said my eyelashes and my hair. Just to move to try to shift my body to get into a comfortable position, that was pure pain. Having the sheets touch me was pure pain. My body felt like it was on fire. I got to the point where I could not move and I was having pains in my chest like I was having a heart attack," she said. "I knew it wasn't a stroke because I felt the pain." Through it all she said the fatigue was extreme. "I was so tired that sometimes I would have to lift my legs to get into the tub and on a few occasions would end up being stuck in the tub because I could not get back out. My body wouldn't work for me to lift it over the tub."
After seeing too many doctors to count, Munnings finally found a medic who noticed the rash on her face and told her it looked like the malar rash also called the butterfly rash. It meant that Munnings could have lupus. After a battery of tests, Munnings was finally diagnosed in the latter part of 2011.
Lupus is a chronic inflammatory disease that occurs when the body's immune system attacks its own tissues and organs. It can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus is the facial rash that resembles the wings of a butterfly unfolding across both cheeks. Some people are born with a tendency toward developing lupus, which could be triggered by infections, certain drugs or even sunlight. While there's no cure for lupus, treatments can help control symptoms. It's important to remember that no two cases are exactly alike.
Munnings said she felt relieved at finally being diagnosed correctly, especially after the frustration she felt when she knew something was wrong with her, but people kept telling her that it was all in her mind.
"I know lupus can be difficult to diagnose, but when you know something is wrong and people are telling you it's all in your mind, it can get frustrating," she said.
Having lupus she said also made her realize just how strong she is and what she can deal with. That's why she said she had the strength to have the pictures taken that she wants to use for her obituary. As for plans, that's the only one she says she can make, as she does not know how she will feel each hour or each day, so she makes no other plans.
"I can't plan ahead. If you want to invite me somewhere I can't tell you, 'yes I will be there', or 'I will not be there'. When I first started the medication after I was diagnosed, a week later I was like, 'yes, I'm back'. I'm a person who is used to doing things for myself...I like to work in my yard, and if anything needs to be fixed I'm going to try it myself, and if I can't do it then I call someone else. The medication was working very well for me and I felt like the old me, so I started cleaning the house from top to bottom. Cleaned the swimming pool, went swimming. Later on that night, I could not move. I [lay] in the bed and I cried. I called the doctor who said that I needed to remember that the woman I was, was gone."
It was after that that she realized she had to take each second and each hour at a time.
"Yes someone could walk outside and get struck by a bus, and their life is over. But with us, it's like, 'do I have the next second, do I have the next minute, do I have the next five minutes'."
She has a handicapped sticker for her car that allows her to park in handicapped parking spaces. When she started feeling good again, she removed it from the window of her car; the doctor told her to leave it up, because she may walk into a store but might not be able to leave without someone carrying her out.
"I just take one day at a time, and through prayer all things are possible," she said. "Right now I'm feeling good, but about two weeks ago I was like, 'Oh, Lord I'm ready to meet you'. When I first started out, I told the doctor...you know what it is for a person who knows that she serves a happy God to be praying to him -- the God of life -- to die."
The mother of a 23-year-old son said that while she may only have been diagnosed in the last two years, when doctors went back through her medical history, they noticed that she showed lupus traits during her pregnancy, going as far back as her childhood sickliness that left everyone wondering what was wrong with her.
Munnings, who works in accounting, said her employer has been understanding of her struggles over the years and has worked with her. When she can't get into the office, they allow her to call in from home.
Even though she has insurance through work, she says lupus has also hit her hard in the pockets. She has to spend at least $600 per month out of pocket for medications and doctor's visits.
Munnings who is a member of Lupus Bahamas 242 also credits the group with helping her to get through.
"What people don't realize is that while we try to keep ourselves on a happy note, we still have the reality of lupus looming over us. I love the members of the group because you realize even though lupus treats everyone differently, at some point we've all gone through the same thing. So it's like, 'How did you go through this', and it's truly a support group, because you can go there feeling in pain, but when you leave, you still have the pain, but you're laughing."
The month of May is recognized around the world as Lupus Awareness Month, and Nassau-based support group Lupus 242 is leading the way in the education about the debilitating disease that affects an estimated 5.5 million people globally. There are no real statistics on the number of people in The Bahamas with lupus. Lupus 242 to date has 50 active members.
Karl McCartney is crafting an excellent career in the Canadian Football League (CFL). Drafted 37th overall, in the fifth round of the CFL Draft of 2010, McCartney signed with the Calgary Stampeders and is carrying on as a Bahamian presence in place of Godfrey Ellis who played his last season with the Stampeders in 2009.
McCartney, as did Ellis, has to make do with competing in the shadow of the higher profiled leagues in the United States, the National Football League (NFL), in particular. Nevertheless, he is determined to do his best to heighten the status of the CFL. He is quite dependable as a linebacker and special teams performer and is proud of his career highlights to date. McCartney played with the rest of his teammates in the 2012 Grey Cup and he considers that a special milestone despite the defeat at the hands of the opposing Toronto Argonauts.
McCartney began to demonstrate his true abilities afield in his rookie season as a special teams standout. He led the team with 19 special teams tackles. In 2012, he was the CFL's No. 3 player in special teams tackles (23). He played 17 regular season games in 2010, seven in 2011, and 18 in 2012, plus the playoff contests.
What's going on in 2013 for McCartney? This is an update he gave me recently:
"The Calgary Stampeders have the best record in the CFL (31-3 as of October 25). I was having a great season (but) then I broke my hand after Week Six. I had surgery and now I'm back in the line-up."
He is the modest one but has high hopes for another trip to the Grey Cup Championship game. McCartney knows he needs to keep getting those opportunities in order to be successful in matching Ellis who was with the team in 2008 when the Stampeders won their last Grey Cup.
McCartney is conscious of the global sports stage and strives for his "special" place in Bahamian sports history. A Grey Cup Championship would put him directly in the company of the Bahamian forerunner on the Stampeders, Ellis. Ever cognizant of playing a bit under the radar in the CFL, McCartney acknowledges being that more determined to make his fellow Bahamians proud by attaining milestones that enhance the country's sports image.
In an earlier interview, McCartney talked about how important it was for him to be representing his country.
"It's about team play in the CFL and not a national team that competes in international events, but it's still about representing my country," he emphasized.
In truth, he runs onto the field in the uniform of the Calgary Stampeders, but it is also as a player born in Nassau, from the Commonwealth of The Bahamas. Just 26, barring career-hampering injuries, McCartney should be around for about another five years and put up numbers that every Bahamian would appreciate.
Continued best wishes Karl!
(To respond to this column, kindly contact Fred Sturrup at email@example.com)
It's a life-threatening disease and topic of discussion that most men "sweep under the rugs." If they have it, they don't talk about it, and they don't bother to allow the doctor to perform the simple check to see if it's developing to catch it at the earliest stage so that it can be treated. When it comes to prostate cancer, most men adopt a don't ask, don't tell strategy. They see the disease as their "shame" because they view it as a threat to their "manhood."
"For a long time, associated with prostate cancer has been erectile dysfunction which means that the man either can't, or has problems performing with his wife on an [intimate] basis," says Valentine "Val" Maura, a member of US Too, a prostate cancer education and support group member. "Also, a lot of men don't get examined because they know they have to take a digital rectal exam (DRE), and when a doctor says you have to drop your pants, most men have all kinds of trepidation. Because of that examination, most men wait until it's kind of late."
Maura himself is one of those men who did not have his first prostate examination until late in life. His first check was performed at age 55. Doctors usually recommend that men without familial history have the exam performed for the first time at age 40, for the disease that occurs when cells in the prostate gland grow out of control. Most men have no early symptoms of prostate cancer, but some have urinary symptoms and discomfort.
"I wanted to know what my situation was and I was eager to find out what my condition was," says Maura of the first time he had his prostate examined. As soon as I got near the examination room I got a little chicken myself," said the 62-year-old. "I was real apprehensive when I found out what it entailed, but I said I had come that far and the only way I would find out my condition was to actually be examined."
Maura did the test and received a clean bill of health on his prostate. With his relief he said came questions and concerns as to whether the examination had been properly done and whether he was really safe. He has had his prostate checked every year since. Although he's not a survivor, he's one of those men willing to stand up and promote the awareness of this life-threatening disease most men shy away from speaking about, because they don't want people to know.
"I became interested in cancer some years ago, in the embryonic stage of the Cancer Society some years ago -- and I don't know if I have an inquiring mind, or a wavering mind -- but if I get involved in something, I like to know about it as much as possible. I don't like to just be a member."
As Us Too celebrates Prostate Cancer Awareness Month during September, and a decade as an organization, Maura says there is a lot more openness about the disease and the test to check for prostate cancer because men like himself and a few brave survivors have been talking about it, but he says there needs to be more talk among men. To encourage that much-needed chat, Us Too will stage its third 1,000-man walk for prostate health on Saturday, September 17 behind the theme "Man to Man, Hand to Hand, Foot to Foot, Mouth to Ear, Communicating Each Other's Prostate Concern." It's the Us Too organization's hope that as the men traverse the walk together they begin to talk together about the disease.
While more men talk about the prostate cancer today than they did 10 years ago, Maura says more communication is still needed about the disease that was once thought of as an old man's disease.
Prostate cancer screening statistics by Us Too over the last five years have for the most part increased during prostate screening clinics staged by the organization as the awareness improved. In 2003, their statistics show a total of 313 persons were tested. In 2004, the number dropped to 231, then again in 2005 to 227. In 2006, a total of 481 persons were tested during the clinics, with 373 presenting in 2007. In 2008, a record 771 tests were performed with 624 prostates checked in 2009, and last year, 687 men presented to have their prostates checked.
Statistics also show that most men reported that they took the test at the urging of their wives. In 2004, two men said their wives encouraged them to take the test. Last year statistics complied by Us Too show that 192 men said they had been encouraged to take the test by their spouses.
Maura says the information now suggests that men should have their prostate checked as early as 35, especially if they have a family history. He says prostate cancer is a disease that can be treated and men don't have to die from it if it's caught early enough.
"Men are worried about their manhood, but aren't doing much, or waiting too late to take the requisite steps to protect the very thing that could destroy their manhood," he says.
With several tests to detect prostate cancer the DRE is an early test to screen for the disease when it is most treatable. Maura say Us Too touts the DRE as it measures the degree of enlargement that a prostate has undergone and medical professionals are able to detect textural changes. A Prostate-Specific Antigen (PSA) Blood Test can be done in conjunction to the DRE.
"The PSA test alone won't be able to tell you what condition the prostate is in, because it has no way of measuring the degree of enlargement the prostate has undergone. There have been studies done that show that the PSA itself has no way of measuring what is happening to the prostate, so you could be falsely feeling safe or you could be way off the mark. The DRE measures the degree of enlargement the prostate has undergone and it has a certain texture that it develops because of the enlargement and so therefore you need both to tell you the true picture, because you can have an elevated PSA count, but it cannot tell you what is actually happening with the prostate itself."
Although not a prostate cancer survivor, Maura says checking your prostate is an overall health concern and that younger men who don't take care of their prostates now will suffer from it later.
"A lot of people think when you get prostate cancer it automatically progresses to stage four and you die, but that's not the case, there's a process where it becomes an embarrassment, it becomes painful, it becomes everything before you eventually die. Men tend to want to protect their manhood, but they're dealing with the very source of their manhood."
While there are no warning signs or symptoms of early prostate cancer, once a malignant tumor causes the prostate gland to swell significantly, or once cancer spreads beyond the prostate, men may have a frequent need to urinate, especially at night; difficulty starting or stopping a stream of urine; a weak or interrupted urinary stream; inability to urinate standing up; painful or burning sensation during urination or ejaculation or blood in their urine or semen. While not symptoms of the cancer itself, they are symptoms of the blockage from the cancer growth within the prostate and surrounding tissues.
Symptoms of advanced prostate cancer include dull, incessant deep pain or stiffness in the pelvis, lower back, ribs or upper thighs; arthritic pain in the bones of those areas. Loss of weight and appetite, fatigue nausea or vomiting, swelling of the lower extremities and weakness or paralysis in the lower limbs.
Maura says he knows of people who are undergoing prostate cancer treatment who have finally come to the realization that they are not going to die and that the disease is not fatal necessarily.
"They now find that because they're undergoing the treatment, they're looking at it much better. They still haven't been brave enough to speak about it in a public forum but they have at least come to grips with the fact that they don't have to die. Some are recovering from the surgery, some only have one or two more regimens of chemotherapy and radiation and are realizing it's a whole different ball game than the death knell they thought it was when they first found out."
Maura says too many men are worried about their manhood so they don't talk about prostate cancer, but he says not talking about it is the thing that could destroy their manhood.
During Prostate Cancer Awareness Month, Us Too will host prostate cancer screening clinics during the month on Tuesday, September 20 at the Elizabeth Estates Clinic, on Thursday, September 22 at the Flamingo Gardens Clinic, on Tuesday, September 27 at the South Beach Clinic and on Thursday, September 29 at the Fleming Street Clinic.
A frequent need to urinate, especially at night.
Difficulty starting or stopping a stream of urine.
A weak or interrupted urinary stream.
Inability to urinate standing up.
A painful or burning sensation during urination or ejaculation.
Blood in urine or semen.
These are not symptoms of the cancer itself. Instead, they are the symptoms of the blockage from the cancer growth within the prostate and surrounding tissues.
ADVANCED PROSTATE CANCER SYMPTOMS
Dull, incessant deep pain or stiffness in the pelvis, lower back, ribs, or upper thighs; arthritic pain in the bones of those areas.
Loss of weight and appetite, fatigue, nausea, or vomiting.
Swelling of the lower extremities.
Weakness or paralysis in the lower limbs.
WHEN TO SEEK MEDICAL CARE
Difficulty initiating and/or stopping a urine stream.
Pain on urination.
Pain on ejaculation.
Dr. Krista Nottage Is Top Award Winner
Friday, March 2nd, 2012 (Nassau, Bahamas) - Natalie Hernandez is a truly extraordinary young woman. In February 2012, Natalie visited Phnom Pehn, Cambodia as a volunteer student educator for Operation Smile, an international medical charity that has provided more than 2 million patient evaluations and over 200,000 free surgeries for children and young adults born with cleft lips, cleft palates and other facial deformities around the world.
Bahamians are watching a tsunami of chronic non-communicable diseases sweep through its population as coronary artery disease and cardiovascular disease has become the number one cause of death in Bahamians. And unless people decide to act and change their way...
I rise on behalf of the Ministry of Health to make my contribution to this 2010/2011 budget presentation and thank the great constituency of Killarney for the opportunity to present this, my third health budget to this honorable chamber.
I wish to congratulate the Rt. Hon. Prime Minister and Minister of Finance, the Hon. Hubert Alexander Ingraham, for his courage in presenting a Budget that is reflective of the realities of the national economic situation and that refused to defer difficult decisions for future generation of leaders.